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poor

adjective Referring to a status wherein a person or persons lack enough money to live at a standard of comfort considered normal in a society. In 2009, 14.3% of Americans were poor; by race, 25% of Hispanics and Blacks are poor, 9% of Whites are poor.

leukemia

Hematology An uncommon–incidence, US 3.5/105/yr—malignant clonal expansion of myeloid or lymphoid cells characterized by an ↑ in circulating WBCs; leukemias may be an incidental finding when evaluating an unrelated clinical problem, or when the expansion compromises BM production of one or more cell lines causing anemia, thrombocytopenia, granulocytopenia; leukemias are divided by chronology–acute or chronic, by cell lineage–lymphoid, myeloid/myelocytic, monocytic or megakaryocytic and divided by stage of maturation or cell size Clinical BM infiltration by leukemia, resulting in anemia, thrombocytopenia, granulocytopenia, immune paralysis, ↓ B cells and CD4–helper T cells, ↑ CD8–suppressor T cells, infiltration and leukostasis, cranial nerve palsies, meningitis, lymphadenopathy, hepatosplenomegaly, testicular and cutaneous involvement, metabolic derangements–eg, ↑ Ca2+, K+, LD, ammonia, weight loss, less commonly, autoimmune hemolytic anemia, pallor and arthralgia Diagnosis Hx, physical exam, peripheral smear Management Chemotherapy, RT, BMT. See Accelerated leukemia, Acute leukemia, Acute lymphocytic leukemia, Acute myelocytic leukemia, Acute promyelocytic leukemia, Adult T-cell leukemia-lymphoma, Aleukemic leukemia, Biphenotypic leukemia, Central nervous system leukemia, Chemotherapy-induced leukemia, Chronic leukemia, Chronic lymphocytic leukemia, Chronic myelocytic leukemia, Chronic myelomonocytic leukemia, Congenital leukemia, Erythroleukemia, FAB classification, Hairy cell leukemia, Hand mirror cell leukemia, Herald state of leukemia, Mast cell leukemia, Megakaryoblastic leukemia, Multilineage leukemia, Plasma cell leukemia, Preleukemia, Prolymphocytic leukemia, Promyelocytic leukemia, Smoldering myeloid leukemia.
Leukemia Acute v. Chronic
Acute leukemia More common in children, 80% are ALL, often before age 10, peak at ages 3–7 in whites, ♂:♀ ratio, 1.3:1 Cell types Early pre-B cell 67%; pre-B cell 18%; B cell 1%; T cell 14%; 50-85% are cALLA positive–common acute lymphocytic leukemia antigen, CD10; 5% have Philadelphia chromosome Clinical ALL is more abrupt than AML, with petechial hemorrhage, bone and abdominal pain, headache and vomiting due to ↑ intracranial pressure, lymphadenopathy, splenomegaly, hepatomegaly Lab 70% have low-grade lymphocytosis–< 20 x 109 when diagnosed Evaluation Acute leukemia immunophenotypic profile Specimen EDTA–lavender top tube and sodium heparin–green top tube, peripheral blood smears Method of analysis Flow cytometry, immunofluorecesence Markers measured CD1, -2, -3, -4, -5, -7, -8, -10, -19. -20, -21, -33, -34, -56, megakaryocytic markers, HLA D/DR, kappa, lambda, TdT Management Protocols vary according to standard- or high-risk clinical features, and may include BMT
Chronic leukemia More common in adults/older children, often myelocytic; CML is Philadelphia chromosome positive; may occur < age 5 with myelomonocytosis, anemia, thrombocytopenia, lymphadenopathy; WBC count < 50 x 109, ≠ HbF, ≠ muraminidase; adult CML comprises 20% of all leukemias Clinical Gradual onset of fatigability, anorexia, splenomegaly; lymphadenopathy is uncommon Lab > 25 x 109/L leukemic cells in blood–often an absolute lymphocytosis of > 15 x 1010/L, < 10% blasts in BM, myeloid:erythroid ratio is 10-30:1, 90% of cases have low-to-absent leukocyte alkaline phosphatase and rarely also, ≠ vitamin B12 and B12-binding capacity Evaluation Chronic leukemia immunophenotype profile Specimen EDTA–lavender top tube and sodium heparin–green top tube, peripheral blood smears Method of analysis Flow cytometry, immunofluorescence Markers measured CD3, -5, -19, -20, -21, kappa, lambda Management see Chemotherapy, Induction Prognosis see Remission.
Leukemia–prognostic features
Acute lymphocytic leukemia
Good Age 2-10, CD10 positivity, hyperdiploid karyotype
Poor Age < 2; >10, B-cell phenotype, especially L2 phenotype by FAB classification, presence of chromosome translocations, CNS involvement, mediastinal masses, high initial WBC count
Acute myelocytic leukemia
Good Younger, presence of Auer rods, rapid therapeutic response
Poor Older, prior malignancy or therapy, multiple chromosome defects  
References in periodicals archive ?
She concluded by saying, "We want patients to know that it is normal to get depressed when they are diagnosed, but it is important to seek help for any depression symptoms because they may lead to poorer outcomes related to their cancer treatment".
The Trust defined people from poorer backgrounds as being in receipt of free school meals.
Almost a third of Russell Group universities - seven institutions across the UK - have seen a drop in the proportion of poorer entrants in the past decade, the analysis shows.
Binay seemed to be courting the local officials of the NUP during the convention when he vowed more funds for the poorer LGUs.
Immigrants from poorer countries are also seen as more likely to abuse or rely on the welfare system, to which they have not contributed, causing taxes to rise (Hainmueller and Hiscox, 2010).
Using planning laws to prevent the betting industry clustering around poorer communities is more difficult, but it ought to be tried.
Researchers analyze big, new urban data-sets - and one study suggests big, wealthy cities may be greener than small, poorer cities
And yet if you were to pinpoint a key difference between the education of wealthier and poorer children in the same schools system, it is the extra curricular things like music lessons that many poorer children don't get the chance to do.
Facilitating the access to credit for the poorer workers is another avenue to increase their income, especially for the self-employed, as this may allow them to benefit from asset-price-generated wealth.
The study also showed that those who quit smoking before their stroke also had less risk of poorer outcomes than current smokers.
It found that just 20% of schools anticipated that pupil premium money would narrow the gap between richer and poorer pupils' results.
Better clinical care and monitoring could halve stillbirths in poorer countries by 2020, the paper adds.